HomeMy WebLinkAboutRoof Inspection Affidavit i
Planning& Development Services
Building&Code Regulation Division
2300 Virginia Avenue
Fort Piercer FL 34982
p a
772462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit#5 LC — (
i,Lyka AA 4`11 ell, licensed as a(n)Contractor*/Engineer/Architect
(Please print name&circle license type) *FS468 Building Inspector
*General,Building,Residential or Roofing Contractor or any individual certified under 468'F.S to make such an inspection.
On or about 10 12-61 , 1 did personally inspect the roof deck nailing,
Date)
work at: '223 F U Cwt VACr l r
(job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most strige t).
_CCC 1-5-? 0-77
g ure and Seal license#
j STATE OF FLORIDA
COUNTY OF� L ,r?e.
Sworn to a d subscribed befo a me this S 1 da of r � e �' 2-0f,
by t-u � N1G CC 11'r, �1 Who Is ersonaliy kno n to me or who has produced
as identt ca I
1-i-Z-11
TYIERJWARSHAW
Notary Public-stateofFlorida
Notary Public,State of Florid � Commission GG 187062
Si nature df iVOta ..' My Comm.Expires Feb 18,2022
N: "Bonded through t4ational NotaryAsmn.
commission Dumber: L<00 `�',' (Seal)
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